Palatka Nursing and Rehab Op LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PALATKA NURSING AND REHAB OP LLC

Doing business as

Radiant Nursing and Rehab at Palatka

Practice address

501 S Palm Ave
Palatka, FL 32177-4147

Phone

(386) 328-1472

NPI assigned

Feb 23, 2022

Last updated

Mar 1, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Yisroel Rosenbaum

Title

President

Phone

(386) 328-1472

Specialties & licenses 1

Addresses

Other names 1

• Radiant Nursing and Rehab at Palatka Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437805033. Details of each certification follow.

• CCN 105805 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105805

Legal name

PALATKA NURSING AND REHAB OP LLC

Doing business as

RADIANT NURSING AND REHAB AT PALATKA

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Jul 1, 1993

Last certification

Feb 6, 2025

Beds

65

Ownership / control type

Corporation

Most recent change of ownership

May 1, 2022

Organization structure

LLCProprietary

Enrollment address

501 S Palm Ave
Palatka, FL 32177-4147

Nursing home name

RADIANT NURSING AND REHAB AT PALATKA

Listed as

Radiant Nursing and Rehab at PalatkaCCN 105805 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

3 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 1, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6556.6 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Axel E. Martinez Irizarry, M.D.

  • Family Medicine Physician
  • Ocala, FL
  • NPI 1689860421

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Moustafa M Eldick, M.D.

  • Internal Medicine Physician
  • Crescent City, FL
  • NPI 1962592907

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1437805033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S PALM AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774147",
            "telephone_number": "386-328-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S PALM AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774147",
            "telephone_number": "386-328-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALATKA NURSING AND REHAB OP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUM",
        "authorized_official_first_name": "YISROEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-328-1472",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiant Nursing and Rehab at Palatka",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hezekiah George Owojuyigbe, M.D, M.P.H.
• Irena Maria Pacanowska-Assefa, MD
• Anthony J Pacitti, M.D.
• Alfredo A Pairot, DDS
• Palatka Lpoc, LLC (Vintage Care of Palatka)
• Palatka Physical Therapy LLC
• Palatka SNF Operations LLC (Palatka Center for Rehabilitation and Healing)
• Kiesha Lashawn Parkinson, RN
• Patrick J Harris D O P a
• Larry William Pederson, R.PH., C.PH.

• Skilled Nursing Facility in Palatka, FL
• Providers in Palatka, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.